Introduction
It is hard to disagree that communities, in general, consider certain mental diseases like schizophrenia to be severe and requiring treatments, while other disorders are perceived as insignificant and temporary conditions that people can merely stop experiencing. Unfortunately, depression and anxiety disorders are usually included in the second group, although they are quite complicated mental health issues. According to Torres (2020), depression is a medical illness that strongly affects how a person acts, thinks, feels, and perceives the environment because depression causes loss of interest, sadness, and other unpleasant experiences. This psychological condition can severely affect one’s ability to perform daily tasks and take care of oneself, as well as cause other physical and emotional challenges (Torres, 2020). Further, as stated by the APA (2022, para. 1), anxiety is a disorder “characterized by feelings of tension, worried thoughts, and physical changes like increased blood pressure”. Anxious persons tend to have intrusive concerns that also negatively affect their daily activities.
Depression and anxiety are common among African Americans, but few representatives of this minority group access quality mental health services. Between 2015-2018, major depressive episodes among Black adults grew from 6.1% to 9.4% (persons aged 18-25) and from 5.7% to 6.3% (persons aged 26-49) (Mental Health America, n.d.). Further, racial discrimination and major events happening in relation to violence against this minority group also affect this issue. For instance, “the rate of black Americans showing clinically significant signs of anxiety or depressive disorders jumped from 36 percent to 41 percent” following the murder of George Floyd (Fowers and Wan, 2020, para. 4). Statistics show that “25% of Black people seek mental health treatment when needed, compared to 40% of White people” (McLean Hospital, 2022, para. 2). However, seeking help from a mental health professional is vital for such patients because otherwise, they may face severe complications and other issues like substance abuse or suicidal thoughts.
Unfortunately, numerous social factors are believed to prevent African Americans from trusting such professionals and accessing their services. Thus, the fact that most mental health helpers are White makes the representatives of this minority group doubt that they can actually receive quality support (Cohut, 2020). Further, “stigma and judgment prevent Black and African American people from seeking treatment for their mental illnesses”, and many of these people know that their conditions are perceived as ‘craziness’ by other persons and even their family members (Mental Health America, n.d., para. 28). As a consequence, stigma and people’s fear to discuss depression and anxiety makes them less educated and aware about the symptoms and need to consult specialists. All these issues and factors require careful consideration, and researching the impact of the listed social factors on African Americans’ readiness to seek help from mental health professionals may give the “Healthy Mind” charity valuable insight into how their services can be promoted.
Research Question
In what ways do social stigma, lack of Black counsellors, cultural incompetence, and general patients’ low awareness about depression and anxiety prevent African Americans’ from accessing mental health services?
Proposed Methodology
Method of Data Collection
To collect data, it is recommended for this research to conduct interviews. As noticed by Barrett and Twycross (2018, p. 63), “interviews give the most direct and straightforward approach to gathering detailed and rich data regarding a particular phenomenon”, especially when referring to a sensitive topic. It was mentioned earlier in the paper that African Americans are concerned with depression and anxiety being seen as ‘craziness’ or insignificant conditions. Therefore, this topic is indeed sensitive, and face-to-face personal interviews may help participants be more relaxed and sincere (Barrett and Twycross, 2018). What is more, online or telephone interviews can be conducted with distant participants. Unstructured interviews with African Americans having anxiety or depression will allow researchers to ask additional questions, focus on the most interesting aspects of responses and develop them (Barrett and Twycross, 2018). At the same time, several unique open-ended questions will be asked during each interview.
Proposed Sample and Recruitment Strategy
Overall, studies generally have differing views about interviews’ sample sizes that are likely to reach saturation. For example, Turner-Bowker et al. (2018, p. 840) believe that “a sample size of 12 may be sufficient for interview studies designed to explore common experiences in a relatively homogeneous sample”. Simultaneously, it is found that all the critical concepts (about 99%) are uncovered only by the 25th interview, and diminishing returns are expected if the number of interviews is larger (Turner-Bowker et al., 2018). As a consequence, it is usually beneficial or meaningful to conduct up to 25 meetings.
Since the selected data collection method is one-on-one interviews, 25 participants will be chosen for the primary interviews and 5 for the additional ones. In order to be able to create a detailed picture of African American depressed and anxious patients’ attitudes toward seeking medical help, it is vital to make sure that the participants vary. More precisely, there will be 5 males and 5 females aged 18-25 and 5 males and 5 females aged 26-49 (all being the representatives of the Black community, having depression and/or anxiety, and not seeking treatment currently). Further, 5 mental health professionals will also be interviewed in order to receive information about their experiences with African American patients visiting them. Finally, it should be insightful to understand the attitudes of friends and family members, so 5 additional interviews will be conducted with Black and White persons not having the identified mental conditions. In total, the sample size of 30 should allow for gathering the required information.
To recruit mental health helpers and Black participants, purposive sampling should be used. As stated by Campbell et al. (2020, pp. 653-654), purposive sampling is “used to select respondents that are most likely to yield appropriate and useful information”. Counsellors will be recruited directly in the “Healthy Mind” charity clinics. Potential Black participants will be found with the help of social media or personal acquaintances, and then 20 individuals will be purposefully selected. Finally, snowball sampling will be utilized to find friends and family members willing to take part in the research. The selected mental health professionals and African American individuals with depression and anxiety will refer to other potential participants.
The Focus of the Data Collection
First of all, some mandatory questions included in each interview with 20 African Americans will be the following: How do you think people perceive your mental condition? Please describe any discriminating experience you faced in relation to your state. What are the reasons you do not seek mental professionals’ help? Would you prefer consulting with a Black helper, and why? Further, the main topics will all 30 participants will be ‘social stigma’, ‘views on anxiety and depression’, ‘cultural awareness and culturally-based approach to treatment’, and ‘education about the two conditions’. The 5 counsellors will be asked to elaborate on the barriers they personally face when trying to help African American clients and their cultural incompetence. Friends and family members (totalling 5 participants) will need to explain their views on depression and anxiety and say whether and why they think such individuals should access treatment. First, these topics and questions will allow all participants to reflect on the causes and effects of their attitudes and probably reassess them. Second, researchers will get a chance to understand the main social barriers by exploring the views of African Americans, counsellors, and community representatives.
Ethical Considerations
Addressing ethical considerations in research is essential to ensure the safety of participants. First, all individuals should be informed that their responses will be anonymous and used only for the purposes of the study, without uncovering the names and backgrounds (Arifin, 2018). Second, participants should be aware that their participation is voluntary and can be terminated at any time they wish (Arifin, 2018). Similarly, neither their participation in general nor their responses will affect their future or be used as the basis for judgement.
Strengths and Limitations of the Approach
The main strength of the selected methodologies is that conducting personal interviews is a promising and effective way to access valuable information and get an understanding of the perceptions of different people with similar characteristics (Barrett and Twycross, 2018). Further, the results will be applicable to the relatively wide population and will definitely help address the social barriers on the way of African Americans seeking mental health support. However, the key limitation is that potential personal acquaintances, stress, or other unpredictable factors may prevent some participants from being sincere during interviews, which will question the applicability of the findings.
Conclusion
This research consultancy report has proposed the following question: “In what ways do social stigma, lack of Black counsellors, cultural incompetence, and general patients’ low awareness about depression and anxiety prevent African Americans’ from accessing mental health services?”. Personal interviews with counsellors, depressed or anxious Black individuals not seeking medical support, and their friends and relatives are believed to help “Healthy Mind” charity become more aware of the social factors influencing attitudes toward these mental conditions and mental help.
Reference List
Arifin, S.R.M. (2018) ‘Ethical considerations in qualitative study’, International Journal of Care Scholars, 1(2), pp. 30-33.
APA (2022) Anxiety. Web.
Barrett, D. and Twycross, A. (2018) ‘Data collection in qualitative research’, Evidence-Based Nursing, 21(3), pp. 63-64.
Campbell, S., et al. (2020) ‘Purposive sampling: complex or simple? Research case examples’, Journal of Research in Nursing, 25(8), pp. 652-661.
Cohut, M. (2020) Racism in mental healthcare: an invisible barrier. Web.
Fowers, A. and Wan, W. (2020) ‘Depression and anxiety spiked among black Americans after George Floyd’s death’, The Washington Post, Web.
McLean Hospital (2022) Black mental health: what you need to know. Web.
Mental Health America (n.d.) Black and African American communities and mental health. Web.
Torres, F. (2020) What is depression? Web.
Turner-Bowker, D. M., et al. (2018) ‘Informing a priori sample size estimation in qualitative concept elicitation interview studies for clinical outcome assessment instrument development’, Value in Health, 21(7), pp. 839-842.